Background
Women with Mullerian agenesis, also known as Mayer-Rokitansky-Küster-Hauser syndrome
(MRKH), have aplasia or hypoplasia of the uterus and vagina. Regular use of dilators
can successfully create a functional vagina in up to 95% of cases. We present 3 women
with Mullerian agenesis who failed dilation therapy due to pain and were subsequently
found to have hymenal anomalies.
Cases
Patients presented at age 16 or 17 to initiate dilation. Initial attempts were discontinued
due to pain. On examination, a septate hymen was identified in 2 patients and a microperforate
hymen in 1 patient. All patients underwent hymenectomy and thereafter continued dilation
with less discomfort.
Summary and Conclusion
These cases illustrate the importance of recognizing and treating hymenal anomalies
in women with Mullerian agenesis to prevent pain, leading to unsuccessful dilation.
Key Words
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Article info
Publication history
Published online: July 29, 2022
Accepted:
July 25,
2022
Received in revised form:
July 11,
2022
Received:
April 1,
2022
Identification
Copyright
© 2022 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.